Reduced myelinated nerve fibre and endoneurial capillary densities in the forearm of diabetic and non-diabetic patients with carpal tunnel syndrome

Niels O B Thomsen, Moaz Mojaddidi, Rayaz Malik, Lars B. Dahlin

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

The underlying basis of carpal tunnel syndrome (CTS) and the basis of its increased incidence in diabetes are unknown. We have quantified pathology in an uncompressed nerve (posterior interosseous nerve, PIN) in the forearm between diabetic and non-diabetic patients with CTS and control subjects. In an age- and gender-matched series, 26 diabetic patients with CTS and 20 non-diabetic patients with CTS underwent biopsy of the PIN at the time of surgical carpal tunnel release. Control subjects consisted of ten PIN biopsies taken postmortem and three biopsies taken at the time of wrist surgery. We found PIN myelinated nerve fibre density significantly reduced in diabetic (mean 5,373/mm2 [95% confidence interval, 4,835-5,911]) and non-diabetic (6,617/mm2 [5,697-7,537]) patients with CTS compared to control subjects (9,109/mm 2 [7,967-10,250], P < 0.001). Furthermore, diabetic patients had a significantly lower density than non-diabetic patients (P < 0.03). Endoneurial capillary density was also reduced in diabetic (58/mm2 [50-66]) and non-diabetic (67/mm2 [55-78]) patients compared to control subjects (86/mm2 [72-101], P < 0.02) with no difference between diabetic and non-diabetic patients with CTS. Our results suggest that a reduction in myelinated nerve fibre and capillary densities may predispose patients, particularly those with diabetes, to develop CTS.

Original languageEnglish
Pages (from-to)785-791
Number of pages7
JournalActa Neuropathologica
Volume118
Issue number6
DOIs
Publication statusPublished - Dec 2009
Externally publishedYes

Fingerprint

Myelinated Nerve Fibers
Carpal Tunnel Syndrome
Forearm
Wrist
Biopsy
Confidence Intervals
Pathology

Keywords

  • Carpal tunnel syndrome
  • Diabetes
  • Myelinated nerve fibre
  • Nerve morphology
  • Peripheral neuropathy

ASJC Scopus subject areas

  • Clinical Neurology
  • Pathology and Forensic Medicine
  • Cellular and Molecular Neuroscience

Cite this

Reduced myelinated nerve fibre and endoneurial capillary densities in the forearm of diabetic and non-diabetic patients with carpal tunnel syndrome. / Thomsen, Niels O B; Mojaddidi, Moaz; Malik, Rayaz; Dahlin, Lars B.

In: Acta Neuropathologica, Vol. 118, No. 6, 12.2009, p. 785-791.

Research output: Contribution to journalArticle

@article{5e64051929614441b96df74eb735d450,
title = "Reduced myelinated nerve fibre and endoneurial capillary densities in the forearm of diabetic and non-diabetic patients with carpal tunnel syndrome",
abstract = "The underlying basis of carpal tunnel syndrome (CTS) and the basis of its increased incidence in diabetes are unknown. We have quantified pathology in an uncompressed nerve (posterior interosseous nerve, PIN) in the forearm between diabetic and non-diabetic patients with CTS and control subjects. In an age- and gender-matched series, 26 diabetic patients with CTS and 20 non-diabetic patients with CTS underwent biopsy of the PIN at the time of surgical carpal tunnel release. Control subjects consisted of ten PIN biopsies taken postmortem and three biopsies taken at the time of wrist surgery. We found PIN myelinated nerve fibre density significantly reduced in diabetic (mean 5,373/mm2 [95{\%} confidence interval, 4,835-5,911]) and non-diabetic (6,617/mm2 [5,697-7,537]) patients with CTS compared to control subjects (9,109/mm 2 [7,967-10,250], P < 0.001). Furthermore, diabetic patients had a significantly lower density than non-diabetic patients (P < 0.03). Endoneurial capillary density was also reduced in diabetic (58/mm2 [50-66]) and non-diabetic (67/mm2 [55-78]) patients compared to control subjects (86/mm2 [72-101], P < 0.02) with no difference between diabetic and non-diabetic patients with CTS. Our results suggest that a reduction in myelinated nerve fibre and capillary densities may predispose patients, particularly those with diabetes, to develop CTS.",
keywords = "Carpal tunnel syndrome, Diabetes, Myelinated nerve fibre, Nerve morphology, Peripheral neuropathy",
author = "Thomsen, {Niels O B} and Moaz Mojaddidi and Rayaz Malik and Dahlin, {Lars B.}",
year = "2009",
month = "12",
doi = "10.1007/s00401-009-0578-0",
language = "English",
volume = "118",
pages = "785--791",
journal = "Acta Neuropathologica",
issn = "0001-6322",
publisher = "Springer Verlag",
number = "6",

}

TY - JOUR

T1 - Reduced myelinated nerve fibre and endoneurial capillary densities in the forearm of diabetic and non-diabetic patients with carpal tunnel syndrome

AU - Thomsen, Niels O B

AU - Mojaddidi, Moaz

AU - Malik, Rayaz

AU - Dahlin, Lars B.

PY - 2009/12

Y1 - 2009/12

N2 - The underlying basis of carpal tunnel syndrome (CTS) and the basis of its increased incidence in diabetes are unknown. We have quantified pathology in an uncompressed nerve (posterior interosseous nerve, PIN) in the forearm between diabetic and non-diabetic patients with CTS and control subjects. In an age- and gender-matched series, 26 diabetic patients with CTS and 20 non-diabetic patients with CTS underwent biopsy of the PIN at the time of surgical carpal tunnel release. Control subjects consisted of ten PIN biopsies taken postmortem and three biopsies taken at the time of wrist surgery. We found PIN myelinated nerve fibre density significantly reduced in diabetic (mean 5,373/mm2 [95% confidence interval, 4,835-5,911]) and non-diabetic (6,617/mm2 [5,697-7,537]) patients with CTS compared to control subjects (9,109/mm 2 [7,967-10,250], P < 0.001). Furthermore, diabetic patients had a significantly lower density than non-diabetic patients (P < 0.03). Endoneurial capillary density was also reduced in diabetic (58/mm2 [50-66]) and non-diabetic (67/mm2 [55-78]) patients compared to control subjects (86/mm2 [72-101], P < 0.02) with no difference between diabetic and non-diabetic patients with CTS. Our results suggest that a reduction in myelinated nerve fibre and capillary densities may predispose patients, particularly those with diabetes, to develop CTS.

AB - The underlying basis of carpal tunnel syndrome (CTS) and the basis of its increased incidence in diabetes are unknown. We have quantified pathology in an uncompressed nerve (posterior interosseous nerve, PIN) in the forearm between diabetic and non-diabetic patients with CTS and control subjects. In an age- and gender-matched series, 26 diabetic patients with CTS and 20 non-diabetic patients with CTS underwent biopsy of the PIN at the time of surgical carpal tunnel release. Control subjects consisted of ten PIN biopsies taken postmortem and three biopsies taken at the time of wrist surgery. We found PIN myelinated nerve fibre density significantly reduced in diabetic (mean 5,373/mm2 [95% confidence interval, 4,835-5,911]) and non-diabetic (6,617/mm2 [5,697-7,537]) patients with CTS compared to control subjects (9,109/mm 2 [7,967-10,250], P < 0.001). Furthermore, diabetic patients had a significantly lower density than non-diabetic patients (P < 0.03). Endoneurial capillary density was also reduced in diabetic (58/mm2 [50-66]) and non-diabetic (67/mm2 [55-78]) patients compared to control subjects (86/mm2 [72-101], P < 0.02) with no difference between diabetic and non-diabetic patients with CTS. Our results suggest that a reduction in myelinated nerve fibre and capillary densities may predispose patients, particularly those with diabetes, to develop CTS.

KW - Carpal tunnel syndrome

KW - Diabetes

KW - Myelinated nerve fibre

KW - Nerve morphology

KW - Peripheral neuropathy

UR - http://www.scopus.com/inward/record.url?scp=71449119702&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=71449119702&partnerID=8YFLogxK

U2 - 10.1007/s00401-009-0578-0

DO - 10.1007/s00401-009-0578-0

M3 - Article

VL - 118

SP - 785

EP - 791

JO - Acta Neuropathologica

JF - Acta Neuropathologica

SN - 0001-6322

IS - 6

ER -